Concourse Sentinel

Medicaid Integrity Analytics

πŸ“ŠOverviewπŸ₯ProvidersπŸ’ŠProcedures🚨WatchlistπŸ”Statistical Outliersβš–οΈCompareπŸ“ˆTrendsπŸ—ΊοΈGeography

Cross-Dataset

πŸ•ΈοΈEntity Networks🏠Home Healthβ›”Exclusions (LEIE)πŸ“‹Context & Disclaimers
πŸ‡ΊπŸ‡ΈAll States
by Concourse

Data: CMS T-MSIS 2018-2024

Source: opendata.hhs.gov

Connecticut Medicaid Provider Spending

CMS T-MSIS data, 2018-2024

Concourse Sentinel connects to large-scale healthcare billing datasets β€” including CMS T-MSIS claims, provider enrollment (PECOS), and federal exclusion lists β€” and runs millions of automated statistical analyses to surface billing anomalies and areas warranting further review.

Cross-Dataset Analysis Available

Watchlist

144 critical

providers flagged

Home Health

Deep Dive

outlier analysis

Entity Networks

AO Analysis

shared ownership detection

Exclusions

LEIE Matches

post-exclusion billing

Total Spending

$28.0B

Total Claims

669.6M

Unique Providers

7.9K

Watchlist

730

144 highest/critical risk

Monthly Spending Trend
Top 10 Providers by Spending
View all providers β†’
Spending by Category
Top 10 Procedures by Spending
CodeDescriptionTotal PaidClaims
T1015Clinic service$3.5B23.8M
99285Emergency dept visit hi mdm$1.5B4.6M
T1502Medication admin visit$1.3B24.3M
99284Emergency dept visit mod mdm$1.2B6.5M
99214Office o/p est mod 30 min$1.1B19.3M
90837Psytx w pt 60 minutes$883.7M10.4M
99213Office o/p est low 20 min$834.5M25.5M
99283Emergency dept visit low mdm$775.6M5.6M
H0020Alcohol and/or drug services; methadone administration and/or service$763.4M59.2M
G0463Hospital outpt clinic visit$556.8M6.3M
View all procedures β†’